Most people associate bruises with varying shades of black, blue, and purple that appear on the skin as a result of tiny broken blood vessels called capillaries. However, bruises can also affect other parts of the body not visible to the naked eye, including internal organs and bones. When bruises affect bone tissue, bone marrow changes alter bone density to produce what’s also referred to as a bone contusion. Here’s what you need to know about spinal bone bruises and how they can be treated.
What Causes Spinal Bone Bruises?
Bones are made up of tissues and layers. A thin, protective layer called the periosteum is above the part where bones come together (subchondral bone). The inner portion (the medulla) contains marrow and microscopic tissues that provide structural support (trabeculae). With spinal bruises, there’s damage affecting tissues or structural parts of a bone, but not an actual break, or fracture. There are three types of bone bruises:
- Subperiosteal hematoma – A buildup of blood just below the membrane covering spinal bones
- Interosseous bruising – The hollow middle part of the bone where yellow and red marrow are housed is affected by bleeding and swelling
- Subchondral lesion – This type of bruising occurs when there is swelling and bleeding between the affected bone and cartilage
Sudden injury from a hard impact or fall is the most common cause of spinal bone bruising. Damage to nearby spinal bones sometimes contributes to bruising. For instance, if a facet joint is fractured, adjacent bones could be bruised because of the trauma that caused the fracture. Injuries from excessive twisting or overextension may also cause spinal bruises.
How Can You Tell If You Have a Spinal Bone Bruise?
Spinal bruises are sometimes mistaken as more common sources of back pain since symptoms can sometimes be vague in nature. Unlike discomfort due to nerve compression, bruising is more likely to cause pain within the affected area. You might also experience:
- Discoloration of the skin
- Visible swelling due to inflammation
- Pain that continues even after visible skin bruising has healed
- Discomfort affected by various movements (e.g. sitting, standing, reaching, or bending)
- Tenderness or back stiffness in the affected area
How Are Bruises of the Spine Diagnosed?
Diagnosis is often a process of elimination based on medical history, a physical examination, and details of what likely caused the resulting pain. If, for example, you fell off your bike recently, this may suggest you have either a bruise or a fracture. An X-ray is often done to rule out a spinal fracture. Because bruises don’t show up on X-rays, an MRI is usually done to make a positive diagnosis.
What Are the Possible Treatments?
Most spinal bone bruises will heal with conservative (non-surgical) treatment efforts. If it’s a minor contusion, you may benefit from rest, the use of anti-inflammatory medications, and the application of cold with an ice or gel pack to the affected area. Even if bruising is more severe, conservative remedies are usually effective. Spinal bone bruise treatment recommendations may also involve:
- Wearing a brace temporarily to limit spine movement
- Modifying activities to give bone tissues time to heal
- Making dietary changes to promote bone healing, such as increasing intake of calcium and vitamin D (which helps with the absorption of calcium)
Some over-the-counter pain medications may inhibit the healing process, so talk to your doctor about other treatment options not involving pain meds if you are experiencing discomfort. Spinal bone bruises usually heal within a few months. If you are still experiencing symptoms beyond this period, also let your doctor or a Los Angeles spine surgeon know.
Not surprisingly, you’re more likely to experience spinal bone bruising if you regularly play high-impact sports or have a physically demanding job that puts pressure on your backbone. Also, having underlying conditions that may weaken bone tissues, such as osteoarthritis, sometimes increases the odds of developing bruises of this nature. Preventive efforts can include wearing protective gear when playing sports, wearing a back-support brace while working, and drinking plenty of water and eating foods like dairy products, fatty fish, and green, leafy veggies.
Though spinal bone bruises are typically easy to remedy, there are other spine conditions that may require minimally invasive surgery such as ACDF, XLIF, or TLIF. Los Angeles residents who believe they might need spinal surgery should contact The Spine Institute today at 310-828-7757.